Transdermally powered mr-conditional medical implant inflator system

ABSTRACT

A wirelessly powered inflatable medical implant system includes a medical provider software application, a patient external controller and a MR-Conditional, nonferrous pump in reservoir implant. The medical provider software application programs the patient external controller for the patient to transmit wireless power and control signals to circuitry in a pump in reservoir implant. In response, the pump in reservoir implant, containing a fluid reservoir and pump package submerged therein, transfers fluid from the reservoir through tubing, and into one or more inflatable medical implants. Submerging the pump package within the reservoir simplifies surgery in males and pump placement in females and provides pump package heatsinking to limit implant overheating.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation-in-part of U.S. patent applicationSer. No. 15/153,382,filed on May 12, 2016, which claims priority to U.S.Provisional Application No. 62/220,593 filed on Sep. 18, 2015. Theentire disclosures of the prior applications are hereby incorporated byreference.

FIELD OF THE INVENTION

The present invention is directed to an apparatus and method fortreating erectile dysfunction, urinary and fecal incontinence, and othermedical problems treatable with inflatable medical implants. Inparticular, the apparatus transmits sufficient transdermal power for itsMR-Conditional pump in reservoir implant to inflate one or moreinflatable medical implants without implanted batteries or otherinternal energy storage. Specifically, the apparatus consists of amedical provider software application for programming and monitoring theapparatus; a patient external controller with a power source andtransdermal power transmitter; a pump in reservoir implant containing asubmerged power receiver, a microcontroller, a nonferrous electricmotor-pump-valve assembly and monitoring sensors; and a pressure relieftube should the pump in reservoir implant fail.

BACKGROUND OF THE INVENTION

Inflatable medical implants with manually operated pumps and reversingswitches placed in the male scrotum or female labia, which transferfluid back and forth between an abdominal reservoir and inflatablepenile cylinders, urethra cuffs and anal cuffs, are known for treatmentof erectile dysfunction, urinary incontinence and fecal incontinence.Some patients, particularly older people with arthritis, find itdifficult to operate the implanted manual pump and reversing switch, andthere is not a comfortable place to implant the pump in females.Therefore, many patients elect not to have treatment.

More recent concepts replace the implanted manual pump and reversingswitch with an electrically driven pump which may be controlled andpowered from an external source. In operation, an external unit sendsenergy and control signals wirelessly to an internal unit, which thenactivates a separately placed pump unit. Signals may also be fed backfrom the internal unit to the external unit to control energy flow.

In certain systems, external alternating current power is transmittedtransdermally by close-coupled magnetic induction typically operating inthe band from 100 KHz to 200 KHz and forming an air core electricaltransformer with its primary winding external to the patient and itssecondary winding internal to the patient. Due to the low permeabilityof air and body tissue, few magnetic flux linkages connect between theseprimary and secondary windings; not like in an iron core transformerwhere most of the magnetic flux is coupled between primary and secondarywindings. Therefore the primary and secondary windings must be placedwithin a few millimeters of each other to safely transmit anyappreciable power, which means the implanted transformer secondary maybe implanted in the dermis, a physically and cosmetically uncomfortablesituation.

In some systems, this placement problem is alleviated with an internalrechargeable battery or capacitor to accumulate enough energy over timefrom a magnetic induction source so that when needed, the pump getsenough power to transfer the required fluid. Other systems use highvoltages to increase power transmission over longer distances, howeverincreasing the transmitted voltage increases the risk of electric shock.In all these systems, the voltage induced in the internal secondarywinding can vary widely due to the patient's placement of the externalprimary windings with respect to the implanted secondary winding.

Full-wave Schottky diode bridge rectifiers with electromagneticinterference filters are known to convert the secondary winding'svarying alternating current voltage into varying direct current voltage.However these full-wave bridge rectifiers have two diode voltage dropsin their current delivery path, which set a limit on their efficiency.

In many of these systems, one or more linear voltage regulators are usedto convert the varying direct current voltage to stable direct currentvoltage to power the electronics and the motor. These linear voltageregulators waste transmitted energy and can generate significant heat inthe implant.

Technology to limit linear voltage regulator inefficiency is known inthe form of a transdermal voltage feedback loop which limits how muchvoltage is applied to the external primary winding and reaches theinternal regulator through the secondary winding, and therefore limitshow much power is transmitted and must be dissipated in the linearregulator. Other systems use switch mode power supplies, which canachieve 70-90% efficiency.

In some systems, brushed direct current and brushless direct currentmotors are known to drive the pump. Both brushed and brushless directcurrent motors have rotors and stators containing ferrous material andare MR-Unsafe. Brushed direct current motors may be connected to switchmode power supply's output though a solid state forward-off-reversingswitch.

Brushless direct current motors are comprised of a direct current to3-phase inverter and a 3-phase induction motor. Such inverters generate3-phase pulse width modulated signals to drive ametal-oxide-semiconductor field-effect transistor 3-phase half controlbridge circuit, which then feeds the motor.

Positive displacement rotating internal gear fluid pumps, which can bebuilt in millimeter diameters, are also known. For submerged operation,such pumps use a hermetically sealed motor magnetically coupled to thepump to prevent fluid from entering the motor. This magnetic coupling isMR-Unsafe.

What is needed is a MR-Safe or MR-Conditional apparatus withoutreduction gears and with efficient power transmission and conversion,which will transmit enough power transdermally to inflate and deflatemedical implants in less time and with greater efficiency, higherreliability, lower implant voltage, in a small implant volume and withminimal surgical impact for men by not involving the scrotum, and,especially for incontinent women, where there is not a comfortable placeto implant a separate pump unit.

SUMMARY OF THE INVENTION

The present invention is directed to an apparatus and method fortreating erectile dysfunction, urinary and fecal incontinence, and othermedical problems treated with inflatable medical implants. Inparticular, the present disclosure relates to a MR-Safe orMR-Conditional apparatus that can transfer enough transdermal energy topower a nonferrous motor, fluid pump and valve combination submerged ina reservoir that is small enough to fit into a patient's abdomen andcapable of inflating and deflating multiple inflatable medical implants,such as dual penile cylinders, anal cuffs and urethra cuffs, in a shortamount of time. For example, the apparatus may inflate or deflate themedical implants in less than 45 seconds.

MR-safe means there are no MRI restrictions for a patient with such animplant. MR-Conditional means a patient with a MR-Conditional implantcan have a MRI study conducted in specific MRI machines, such as1.5-tesla MRI machines. The apparatus disclosed has an implant which iscomprised of nonferrous motors, pumps and valves; however, the implantmay contain electronic components or conductors which may beMR-Conditional.

The apparatus includes a medical provider software application, apatient external controller, and a MR-safe or MR-Conditional pump inreservoir implant. The medical provider software application, running onany computing device, such as a tablet, PC or MAC, allows the medicalprovider to individually program each patient's patient externalcontroller for their personal use, to monitor each patient's pump inreservoir implant usage, and to perform statistical analysis of usageacross patients. The medical provider software application communicateswith the patient external controller via wired or wirelesscommunications, such as Ethernet, radio, Wi-Fi or Bluetooth.

The patient external controller contains a rechargeable battery powersource, such as a Lithium Ion battery; a patient display, such as atouch panel liquid crystal display, and control switches, such aspushbuttons; a microcontroller; a transdermal power transmitter whichgenerates a high frequency, evanescent electromagnetic field from apower amplifier and resonant antenna; a bidirectional radio link withthe pump in reservoir implant; and a bidirectional link with the medicalprovider software application.

In operation, the medical provider uses the medical provider softwareapplication to program the patient external controller for use by thespecific patient. The patient then activates a control on the patientexternal controller to transmit control signals, data and power to thepump in reservoir implant to inflate or deflate one or more inflatablemedical implants. The pump in reservoir implant sends performance databack to the patient external controller so the patient may monitorimplant operation on the display. The patient external controller storesthe data for later transmission back to the medical provider softwareapplication so the medical provider can monitor and, if necessary,update pump in reservoir implant operation.

The pump in reservoir implant includes a biocompatible case enclosing areservoir containing an isotonic fluid, such as normal saline, which ispumped into and out of one or more inflatable medical implants to causeinflation and deflation. The fluid also acts as a heat sink for asubmerged cylinder containing circular electronic circuit boards and anonferrous pump assembly comprising a 3-phase squirrel cage motor, aninternal gear pump, and one or more piezoelectric valves. The amount offluid transferred by the pump may be controlled by powering the pumpsfor a fixed number of rotations or by pump output pressure.

One or more independently controlled piezoelectric valves achieveindependent control of one or more inflatable medical implants to treatmultiple medical problems and to prevent leakage through the pump. Thatis, when multiple medical implants are included, each medical implant isconnected to a dedicated piezoelectric valve. A pressure relief tube,with its top under the dermis, is provided for deflation by the medicalprovider should the pump in reservoir implant fail.

Sensors in the pump in reservoir implant measure pumping parameters foroptimizing pump performance and monitoring for implant failures. Sensordata may include reservoir and inflatable medical implant pressure, pumpspeed, motor current and voltage, temperature, leaks, and electricalshorts.

The data from the sensors is also sent to the patient externalcontroller for monitoring by the patient and for storage for lateranalysis by the medical provider. The medical provider may thennoninvasively change inflation parameters by reprogramming the patientexternal controller via the medical provider software application.

No power is stored internally in the pump in reservoir implant, so theimplant is completely passive at all times except when powered by thepatient external controller. A data link handshake and foreign objectdetection is provided to prevent the implant from being powered by theMRI machine's radio frequency transmitter or other sources, or for powerto be transmitted to foreign objects.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a diagram illustrating a transdermally powered MR-Conditionalmedical implant inflator system

FIG. 2 is a bock diagram of the medical provider software application.

FIG. 3A is an illustration of an example patient external controller.

FIG. 3B is a block diagram representation of the components of thepatient external controller's electronic circuitry.

FIG. 4A shows a diagram of an MR-Conditional pump in reservoir implantoperating a single inflatable medical implant.

FIG. 4B shows a diagram of an MR-Conditional pump in reservoir implantoperating three inflatable medical implants.

FIG. 5A shows the windings of a nonferrous 4-pole squirrel cage motor.

FIG. 5B shows a nonferrous 4-pole squirrel cage motor with the rotor andstator encapsulated.

FIG. 6 shows an MR-Unsafe pump in reservoir implant operating threeinflatable medical implants.

FIG. 7 shows a block diagram of power electronics that may be used inthe inflatable medical implant system.

FIG. 8 shows a pump package illustrating the circuit board, pump andvalve arrangement.

DETAILED DESCRIPTION OF THE INVENTION

The present invention is directed to an apparatus and method fortreating erectile dysfunction, urinary and fecal incontinence and otherconditions treated by inflatable medical implants. The apparatusincludes an MR-Safe or MR-Conditional transdermally powered inflator forinflatable medical implants. As shown in FIG. 1, the apparatus includesa medical provider software application 120, a patient externalcontroller 130, and a pump in reservoir implant 140, which can inflateand deflate one or more inflatable medical implants 150 in a short timeperiod by transferring isotonic fluid at a particular or varyingpressure. For example, the implants may be inflated or deflated in 45second by transferring 60 milliliters of isotonic fluid at 25 pounds persquare inch pressure.

The pump in reservoir implant 140 is surgically placed in a patient's100 abdomen 102, and a flexible tube 144 is run from it to theinflatable medical implant 150. The pump in reservoir implant containsall the pumping components, which obviates the need for surgeons toenter the scrotum in males or providing uncomfortable pump locations infemales. As shown in FIG. 1, a pressure relief tube 143 is placed in theabdomen 102 close to the dermis 101 for pump in reservoir implant 140deflation by the medical provider should the apparatus fail.

The medical provider software application 120, executed on a computingdevice 121, such as a desktop, laptop, smartphone, or tablet, allows themedical provider to set, monitor and noninvasively change inflatablemedical implant 150 inflation parameters stored in the patient externalcontroller 130 for transmission to the pump in reservoir implant 140.Inflation parameters may originate from the medical provider, theapparatus provider or from performance data received from sensors placedin the pump in reservoir implant 140. The medical provider softwareapplication 120 also collects patient external controller 130 data frommultiple patients so trends in usage and performance may be analyzed fordetermining settings and for scientific papers.

A block diagram of the software modules contained in the medicalprovider software application 120 is shown in FIG. 2. The implantparameter module 201 provides the medical provider with the capabilityto set and update the patient external controller's 130 software andinflation parameters, and to monitor implant operation. The medicalprovider may set parameters including the amount of fluid that the pumptransfers and at what speed for inflation and deflation. The medicalprovider may set the amount of fluid and speed parameters as constantvalues, or may set the parameters to change depending on particulartimes of the day. For example, to increase anal and urinary artificialsphincter life, the medical provider may want to apply less pressure tothe artificial sphincter at night, when less pressure is needed insupine patients, thereby reducing tissue wear. Pump operating time andoutput pressure data fed back to the module is then available to assistthe medical provider in finding this minimum, and noninvasivelyadjusting it over time, as tissue atrophies.

Data from the implant parameter module 201 is stored in an encryptedpatient data base module 202. The patient data base module 202 may storepatient implant data for all the medical provider's patients. Ananalytics module 203 provides the medical provider with the capabilityto study trends in patient data contained in the patient data base 202.Analysis may include looking at atrophy rates of artificial sphincterpatients with specific devices, and warning that a particular device isabout to fail.

An executive module 210 controls and oversees the use of other modulesby providing services such as such a logon, logoff and module selection.A graphic user interface module 220 provides the displays and controlsfor the medical provider to interface with the application's modules.

When in range, such as during office visits or hospitalizations, acommunications module 230 provides for computer instructions and datatransfer between the medical provider software application 120 and thepatient external controller 130 using encrypted transmissions over astandard communications network 122, such as Ethernet, USB drive,Bluetooth or Wi-Fi, as shown in FIG. 1. The communications module 230may also retrieve implant performance data stored in the patientexternal controller 130. A security module 250 provides data encryptionand medical provider authentication. And, a multiplatform interfacemodule 260 provides application operation across different medicalprovider computing devices 121 with different screen sizes. All modulesoftware may be updated from time to time by the apparatus provider viadisk and over the internet.

A patient external controller 130, in communication with the medicalprovider software application 120 and the pump in reservoir implant 140,receives and stores inflation data and computer instruction updates fromthe medical provider software application 120, and sends data, power andcomputer instructions to the pump in reservoir implant 140. It alsoreceives data back from the pump in reservoir implant 140 which may beviewed by the patient and stored for retransmission to the medicalprovider software application 120, thus allowing the patient totransdermally activate, control and power the implant and for themedical provider to reprogram and monitor implant usage and performance,respectively.

FIG. 3A illustrates an example of a hand-held patient externalcontroller. As shown in the Figure, the patient external controllerincludes an external controller case 301 with a touch screen display 311and patient control 305 buttons. Patient controls 305 may be providedvia push buttons, a touch screen display 311 or both. They may include“On, Off, Inflate, and Deflate.” Multiple controls are provided forimplants operating more than one inflatable medical implant 150. Forexample, the buttons may control inflation and deflation of threeinflatable medical implants 150. The center button is a “Power On andOff” button. The patient external controller 130 may also have a lanyard312 which allows patients to hang the controller from the neck while inuse. In operation, the patient may place the external controller case301 or the transmitter resonator pad 310 on, or in proximity to, thedermis 101, over the pump in reservoir implant 140, and then operate thedesired patient control 305.

FIG. 3B is a block diagram representation of the patient externalcontroller's 130 electronic circuitry. It contains a rechargeablebattery power source 304, such as Lithium Ion or Nickel Metal Hydridebatteries, to power the apparatus. When not in use, the patient externalcontroller 130 may sit in a battery charging station 302, which providesdirect current power to charge the rechargeable battery power source304. Overcurrent, short circuit and over temperature protection may beprovided. The battery charging station 302 may be powered from 120-220volt (V), 50-60 hertz (Hz) wall outlet connections or 12 V storagebatteries.

When the “On” patient control 305 is selected, the rechargeable batterypower source 304 supplies power to the patient external controller 130to energize its functions and await commands from the patient viapatient controls 305 or from the medical provider via the communicationsport 306. Upon activating another control, a signal is sent to acontroller microcontroller 307, such as a TMS 320 seriesmicrocontroller, which contains a nonvolatile memory for storing itsexecutable computer instructions, medical provider's settings, andimplants usage data, to institute and control apparatus actions. Shouldan action include operation of the pump in reservoir implant 140, ahandshake is first conducted with the pump in reservoir implant 140 overthe bidirectional communications link 132 to ensure it is ready foroperation, and foreign object detection is initiated for safety.

Here, the controller microcontroller 307, connected to the powertransmitting unit 308 over a standard bus, such as an I²C serialinterface bus, sends handshake messages to the power transmitting unit308 for transmission through the transmitter resonator 309 to pump inreservoir implant 140. Proper messages must be received back from thepump in reservoir implant 140 for the action to continue. The controllermicrocontroller 307 may be programmed to stop operation if thebidirectional communications link 132 signal is lost, a preset pump inreservoir implant 140 safety parameter is exceeded, or a foreign objectis detected. The controller microcontroller 307 may turn off power if nopatient control 305 is received after a preset time interval.

Upon completion of the handshake and safety checks, the powertransmitting unit 308 generates and transmits evanescent radio frequencytransdermal power 131 via a transmitting resonator 309 to the pump inreservoir implant 130, and may operate in the 6 MHz to 7 MHz band, adecade below the 63.87 MHz radio frequency of 1.5 tesla MRI machines.

As shown in FIG. 1, evanescent power transmission 131 may be used totransmit power to the pump in reservoir implant 140, as opposed to aclose-coupled magnetic induction power transmission, because it providesmore efficient, longer distance, higher power operation at a lowervoltage. The transmitter resonator 309 may transmit over 5 watts ofpower, across more than 2-inches of dermis 101, tissue and fat, to thepump in reservoir implant 140.

The transmitter resonator 309 includes a wire coil and a matchingcapacitor network combination which resonates at the desiredtransmission frequency, such as 6.78 MHz. Wired coils may be located inboth the patient external controller case 301 and in the transmitterresonator pad 310, which may make it easier for the patient to hold thewire coil on the skin over the implant. The transmitter resonator pad310 may connect to the external controller case 301 via a plugin cable311. Plugging the cable 311 into the external controller case 301disconnects the case's wire coil.

As shown in FIG. 1, the pump in reservoir implant 140 includes an outerflexible reservoir case 141, which may be elliptical in shape and holdisotonic fluid 145 as the working fluid for inflatable medical implants150. As noted, the inflatable medical implants may be penile cylinderimplants, urethra cuff implants or anal cuff implants. The amount ofisotonic fluid may depend on the implant and desired use. For example,75 milliliters of isotonic fluid may be used with a penile cylinderimplant.

The pump in reservoir implant 140 further includes a pump package 142,which may be in the form of a cylinder, 55 millimeters in diameter by 45millimeters long and submerged in the isotonic fluid 145. A flexibletube 144 with a connector 146 carries the isotonic fluid 145 to and frominflatable medical implants 150. A pressure relief tube 143 is alsoincluded, should the apparatus fail.

The reservoir case 141 may have a biologically inert outer wall with aninsulating material, such as Nomex, molded into the wall to reduce heattransfer rate from the isotonic fluid to the patient during low dutycycle inflation and deflation. The unfilled reservoir may be folded intoa cylindrical shape to ease insertion by the surgeon. The surgeon mayinsert the reservoir case 141 into the patient's abdomen 102 and thenfill it with isotonic fluid 145. The isotonic fluid 145 is the pump'soperating fluid, provides a heat sink for the pump package 142, and doesnot change the patient's local electrolytic balance should leakageoccur.

As shown in FIGS. 4A, 4B and 6, the apparatus may inflate and deflateany combination of penile cylinder implants 417, urethra cuff implants418, anal cuff implants 419, and other inflatable medical implants. FIG.4A illustrates a pump in reservoir implant 140 operating a singleinflatable medical implant 150. FIG. 4B shows a pump in reservoirimplant 140 operating three inflatable medical implants: a penilecylinder implant 417, a urethra cuff implant 418, and an anal cuffimplant 419.

The pump in reservoir implant 140 may be MR-Conditional or MR-Safe, withcomponents that may not translate, rotate, excessively heat or cause MRIpicture distortion when introduced into certain MRI machines. As shownin FIG. 6, the pump in reservoir implant 140 may also be implementedwith components which contain MR-Unsafe ferrous materials.

The MR-Safe or MR-Conditional pump in reservoir implant 140 apparatusmay inflate and deflate penile cylinder implants 417. In order toinflate and deflate the implants quickly, the pump may pump 60milliliters of fluid at 25 pounds per square inch pressure in 45seconds, which includes a safety factor. Pumping equations show thatthis is equivalent to providing 0.23 watts of pumping power at thepenile cylinder implant 417. Since cuffs require less than 1/10 ^(th)the amount of fluid transfer than for cylinders, requirements are lessstringent for these implants.

MR-Unsafe ferrous brushed direct current and brushless direct currentelectric motors coupled to ferrous containing positive displacementinternal gear pumps, which meet these requirements, may be used. Thesemotors use ferrous materials to greatly increase torque by linkingmagnetic flux between the motor's stator and rotor such that very littleleakage flux is generated. For such motors, removing ferrous materialsfor MRI safety reduces flux linkages, thereby greatly reducing torqueand power output. In such motors, some torque can be bought back byincreasing motor diameter and applied voltage. However, minimizing theseparameters is desirable.

Furthermore, for positive displacement rotary internal gear pumps,dynamic sealing allows the gears to move while maintaining separationbetween the pump's inlet and outlet. These dynamic seals are maintainedas the gears rotate. However, there must be some clearances for thegears to move. These clearances allow fluid to leak back from thehigh-pressure outlet to the low-pressure inlet, thereby reducing pumpefficiency, especially at low pump output pressures, such as 25 poundsper square inch, and will cause fluid leakage back and forth between thereservoir case 141 and the inflatable medical implant 150 even when thepump is not in operation.

A nonferrous combination of a 3-phase squirrel cage motor and positivedisplacement internal gear pump may also be used. For example, a 50,000revolutions per minute motor, reduction gear and low speed pumpcombination, 10 millimeters in diameter, may be used. To maximizemotor-pump efficiency and minimize motor diameter without usingreduction gears with their efficiency loss, a nonferrous 50 millimeterdiameter squirrel cage motor 409, operating at 4000 revolutions perminute, power by a 24 volt direct current input 3-phase power inverter408 and driving a 10 millimeter diameter nonferrous positivedisplacement internal gear pump 410 may be used.

An electrically operated, nonferrous piezoelectric valve 411 may beadded at the internal gear pump 410 connection with the inflatablemedical implant 150 to prevent fluid leakage back to the reservoirthrough the pump, and vice versa. Individually operating a stack of suchvalves allows a single motor and pump to operate multiple inflatablemedical implants, providing a significant cost and size saving. Lessthan 5 watts of transdermal power is needed to power the pump inreservoir implant.

Details of the pump in reservoir implant 140 operating a singleinflatable medical implant 150 are shown in FIG. 4A. In the figure, areservoir case 141 contains a pump package 142 which includes atransdermal power receiver resonator 403; electrical components mountedon circular circuit boards 440; a nonferrous pump assembly, comprising a3-phase squirrel cage motor 409, an internal gear pump 410, apiezoelectric valve 411; and pump speed and pressure sensors 412, allsubmerged in an isotonic fluid 145.

FIGS. 5A and 5B illustrate a squirrel cage motor, supplied with 3-phasealternating current power, and able to be operated at various speeds.For example, a 50 millimeter diameter by 25 millimeter long, 3-phase4-pole squirrel cage motor, supplied with 3-phase 14.9 volts alternatingcurrent power, and operating at 4,000 revolutions per minute, may beused. FIG. 5A shows the motor's 4-pole stator windings 501 and the rotorbars 502 with their short circuiting endplates. In FIG. 5B, the statorwindings 501 and the rotor bars 502 are encapsulated in molded plasticto reduce windage losses and to stabilize the rotor under centrifugalforce. A 3-phase squirrel cage motor has the advantages of small size,self-starting, high speed operation. Squirrel cage motors do not usebrushes or slip rings, wear items which reduce motor life.

As shown in FIG. 4A and FIG. 8, the submerged squirrel cage motor 409drives a submerged nonferrous, positive displacement rotary internalgear pump 410, where one pump orifice is open to the reservoir throughthe reservoir orifice tube 810. The nonferrous internal gear pump may be10 millimeters in diameter and 10 millimeters long and have shaft sealsto prevent fluid from entering the squirrel cage motor 409.

The other internal gear pump 410 orifice may be assembled to a 10millimeter diameter nonferrous piezoelectric valve 411 orifice. Thevalve is closed when not in use to prevent leakage of fluid through theinternal gear pump 410.

An external orifice tube 800 connects the piezoelectric valve's 411other orifice to a connector 146 placed through the reservoir case 141for attachment of the flexible tube 144 during surgery when the surgeonthreads the flexible tube 144 from the reservoir case 141 to theinflatable medical implant 150 and connects it to the pump in reservoirimplant using connector 146.

FIG. 4B shows individually controlled piezoelectric stacked valves 420operating three implants: a dual penile cylinder implant 417, a urethracuff implant 418 and an anal cuff implant 419. A computer interlock isprovided so only one valve can be open at a time.

Implant electronics driving the pump 441, may be housed onmilitary-grade, multilayer, coated circular circuit boards 440 forphysical damage and short circuit protection and moisture-proofing. Asshown in FIG. 8, the circular circuit boards 440 may be 50 millimetersin diameter and have holes in their centers for placement around the 10millimeter diameter internal gear pump 410 and piezoelectric valve 411.The boards and their components are, at least, MR-Conditional and may beMR-Safe.

As shown in FIG. 7 and FIG. 4A, the receive resonator 403 may receiveevanescent power transmissions 131 transdermally from the transmittingresonator 309. Additionally, it may be used for the bidirectionalcommunication link 132 with the patient external controller 130. Thebidirectional communications unit 404 codes and decodes thesebidirectional signals for the implant microcontroller 406.

The receiver resonator 403 includes a resonant circuit made up of annonferrous wire coil 700 inductor, which may be in the shape of a 45millimeter diameter circle, and a MRI filter/matching network 701, whichmay resonate at 6.78 MHz and filter out the higher frequencytransmissions of MRI machines, such as 63.9 MHz from 1.5 tesla MRImachines. The wire coil 700 may be etched onto the circular circuitboard 440, molded into the reservoir case 141, or housed in a separatecase which, in obese patients, may be located under the dermis 101. Thereceiver resonator's 403 output voltage may vary widely from patient topatient with placement of the transmitter resonator 309 with respect tocoil 700.

The receiver resonator 403 feeds alternating current power to a powerconditioning unit 405, which converts the varying received alternatingcurrent voltage to stable direct current voltages for the electronics,motor and sensors. First, a low power low voltage power supply maygenerate 5 volts direct current to power the electronic components andsensors. The power conditioning unit 405 may use Schottky diodes in afull wave bridge rectifier 710 configuration to convert the alternatingcurrent voltage into direct current. An electromagnetic interferencefilter 711 is applied to remove diode switching transient noise.

Since the electromagnetic interference filtered 711 output voltage canvary widely, a low voltage switch mode power supply 712 may providestable 5 volts direct current. The low voltage switch mode power supply712 may contain an under voltage-over voltage protection circuit whichonly energizes the switch mode power supply when appropriate directcurrent voltage appears at its input to produce its desired output.Switch mode power supplies obviate the need for inefficient linearregulators and are more efficient than voltage feedback loops to thepatient external controller 130.

Upon reception of power from the low voltage switch mode power supply712, an implant microcontroller 406 is energized, does a handshake withthe patient external controller 130 and self-tests for problems in thepump in reservoir implant 130, such as out of range temperature andpressure and electric current leakage. The implant microcontroller 406then sends status data back to the patient external controller 130,which, if all is well, energizes the patient controls 305.

The implant microcontroller 406, such as a MR-Safe MSP430 or C2000series microcontroller, may contain an encrypted nonvolatile memory, areduced instruction set computer, a pulse width modulation unit, atleast one analog-to-digital converter, at least one data bus, andself-test capability.

Upon reception of inflation or deflation signals and data from thepatient external controller 130, the implant microprocessor 406 may turnon a gallium nitride transistor, programmable totem pole boost powerconverter 713 to generate stable high voltage direct current 140, suchas 24 volts direct current. The gallium nitride transistor, programmabletotem pole power converter 713 uses gallium nitride high electronmobility field effect transistor switches, which achieve lower lossesthan silicon-based components, to nominally provide 24 volts directcurrent to power the 3-power inverter 408 for the 3-phase squirrel cagemotor 409. The gallium nitride transistor, totem pole boost powerconverter 713 operates at a lower input voltage, such as 12 volts directcurrent, than its output voltage, thereby allowing for lower evanescentpower transmission 131 voltage from a lower voltage rechargeable batterypower source 304, for example 12 volts direct current, in the patientexternal controller 130, which results in less cost and greater patientsafety.

The implant microcontroller 406 uses the pulse width modulation voltagecontrol 714 path to sense the alternating current input voltage,determines when that voltage crosses zero and then sends pulse widthmodulation signals to turn on and turn off gallium nitride half-bridgetransistors in an inductive boost converter configuration to achievealternating current to direct current boost conversion to provide thehigh direct current voltage power 420. The high direct current voltagepower 420 voltage is fed back to the implant microprocessor 406 forclosed loop control of the voltage by varying the pulse widthmodulation.

The high voltage direct current 420 output of the gallium nitridetransistor, programmable totem pole power converter 713 is then invertedto 3-phase alternating current by a 3-phase power inverter 408controlled by the implant microcontroller 406. The frequency and thenumber of sinusoidal cycles to be generated may be set from the medicalprovider software application 120. For a 4-pole, 4000 revolution perminute squirrel cage motor, the implant microcontroller 406's pulsewidth modulation unit, operating at 50 KHz, may generate three 200 Hzpulse width modulation sinusoids set 120 degrees apart for low harmonicdistortion losses. Soft pulse width modulation gallium nitridetransistor startup is used to decrease losses from transistor switchingtransients. Motor direction, and therefore inflatable medical implant150 inflation or deflation, is achieved by switching two phases of thethree 3-phase signals.

The sinusoidal pulse width modulation signals are input to three 3-phasehalf-bridge gate drivers 720, which, in turn, drive three 3-phase halfcontrol bridges 721, to generate 3-phase power to drive the motor.Current and voltage feedback 722 from the 3-phase half control bridges721 is used in the implant microcontroller 406 to provide stableoperation of this nonferrous low stator impedance motor, and detectfaults for safe operation.

In operation, the motor, which drives the pump, sees a varying load. Atthe start of the pumping cycle, the pump sees high pressure at its inputand low pressures is at its output and requires reduced motor torque,and therefore power, to operate. At the end of the cycle, the oppositeis true. Efficiency of the pump and motor combination is achieved bycalculating and applying the optimum 3-phase voltage at the optimum3-phase frequency continuously over the pumping cycle. This optimizationmay be achieved by the implant microprocessor 406 using the pulse widthmodulation voltage control 714 feedback loop and the current and voltagefeedback 722 loop to set the high direct current voltage 420 and the3-Phase pulse width modulation signal 723 to control the 3-phasesquirrel cage motor's 409 speed and torque.

Alternatively, the gallium nitride transistor, programmable totem poleboost power converter 713 may be replaced by a Schottky diode full wavebridge rectifier and electromagnetic interference filter, and thevarying high direct current voltage power 420 is fed directly to the3-phase half control bridges 721, which act as both a voltage regulatorand a direct current to alternating current inverter. The implantmicroprocessor then generates the correct pulse width modulation signalsfor the varying high direct current voltage power 420 when it computesthe pulse width modulation signals for the 3-phase squirrel cage motor409. Additionally it provides over and under voltage protection for thevarying high direct current voltage power 420.

The implant microcontroller 406 also receives, processes, and formatsimplant performance and safety data for transmission to the patientexternal controller 130. In some implementations, additionalanalog-to-digital and digital-to-analog integrated circuit are necessaryto handle all the sensor data.

Pump pressure and motor speed sensors 412 are provided along withreservoir pressure and temperature sensors 414. Pressure and speed datais sent to the implant microcontroller 406. The pressure and speed datamay be used for automatic cutoff should the pump run over or under speedlimits, or on the occurrence of leakage, over inflation or a fluidblockage.

The pressure and speed data may also be used to help the medicalprovider set the amount of fluid to be transferred that is best suitedfor the patient. Reservoir pressure and temperature sensors 413 may beincluded on the circular circuit boards 440 to send pressure andtemperature data to the implant microcontroller 406 for high temperaturecutoff should the isotonic fluid 145 overheat. Additionally, integratedcircuit chips used in the power receiving unit 405 and implantmicrocontroller 406 may have internal temperatures sensors that turn offthe chip in over temperature situations.

Should the apparatus fail with an inflatable medical implant 150, suchas a penile cylinder implant 417, inflated, a pressure relief tube 143is provided to allow medical providers to manually deflate theinflatable medical implant 150 by inserting a small bore hypodermicneedle into the pressure relief tube 143 and draw out the inflatingfluid. One end of the tube is located at the inflatable medical implant150 and the other end just below the dermis 101.

FIG. 6 shows a diagram of a MR-Unsafe pump in reservoir implantimplementation. The implementation of FIG. 6 includes many of the samecomponents already described in FIGS. 4A and 4B. However, in FIG. 6, the3-phase power inverter and nonferrous pump and motor 408, 409, 410, fromFIGS. 4A and 4B are replaced by an inflate-off-deflate switch 608,direct current motor 609 and internal gear pump 610.

Coupling between the direct current motor 609 and the internal gear pump610 may be magnetic, allowing the pump to be in submerged in theisotonic fluid 145 without the need for seals in the pump, therebyincreasing efficiency and reliability. Also, the 3-phase power inverter408 is replaced by connecting the 713 gallium nitride transistor,programmable totem pole boost power converter's 713 high direct currentvoltage power 420 through an implant microcontroller 406 controlledhalf-bridge reversing direct current power control inflate-off-deflateswitch 608, to turn the motor on and off and to reverse its direction.

FIG. 8 shows the pump package 142 illustrating the circular circuitboard 440, squirrel cage motor 409 and piezoelectric valve 411arrangement. In the pump package 142, an internal gear pump orifice 410directly connects to a piezoelectric valve 411 orifice. A reservoirorifice tube 810 then connects the other internal gear pump 410 orificeto inside the reservoir case 141 in contact with the isotonic fluid 145.An external orifice tube 800 connects the other piezoelectric valve's411 orifice to a connector 146 leading outside of the reservoir case141. The figure also shows a single circular circuit board 440 mountedaround a piezoelectric valve 411.

As an added benefit to pumping fluid to inflate and deflate inflatablemedical implants, this apparatus may provide vibrating penile cylinderimplants 417 by modulating the implant microcontroller's 406 3-phasepulse width modulation signal, or by adding a pressure transducer andaudio power amplifier (not shown) in fluid communications with aninflatable penile implant's input flexible tube.

1. A pump in reservoir implant for inflating inflatable medical implantscomprising: at least one nonferrous motor; a nonferrous fluid pumpconnected to the at least one nonferrous motor; and at least onenonferrous valve connected to the nonferrous fluid pump, configured toallow fluid to pass from the pump to an inflatable medical implant. 2.The pump in reservoir implant of claim 1, wherein at least onenonferrous motor includes a 3-phase nonferrous induction or synchronousmotor; wherein the nonferrous fluid pump includes a nonferrous gearpump; and wherein the at least one nonferrous valve includes multiple,independently electrically controlled nonferrous fluid valves.
 3. Thepump in reservoir implant of claim 1, further comprising multipleindependently controlled valves connected to multiple inflatable medicalimplants.
 4. The pump in reservoir implant of claim 1, wherein thenonferrous motor, the nonferrous pump and the nonferrous valves aresubmerges in a fluid.
 5. A transdermally powered inflatable medicalimplant inflator system comprising: a pump in reservoir implant, thepump in reservoir implant including: a biologically compatible,fluid-tight reservoir case containing an isotonic fluid; a pump packagesubmerged in the reservoir case comprising at least one circuit board,at least one motor, at least one pump, at least one valve, at least onepressure sensor and at least one temperature sensor; at least oneflexible tube; and at least one inflatable medical implant in fluidcommunication with the pump in reservoir implant through the flexibletube.
 6. The inflatable medical implant inflator system of claim 5,further comprising a coiled loop inductor and a matching networkconfigured to provide transdermal resonant reception of radio frequencyelectromagnetic field energy to directly inflate the at least oneinflatable medical implant.
 7. The inflatable medical implant inflatorsystem of claim 5, further comprising a power condition unit containing:a low voltage power supply in communication with a coil and matchingnetwork, wherein the low voltage power supply includes a Schottky diodefull wave rectifier, an electromagnetic interference filter and a switchmode power supply to generate low voltage direct current power to powerelectronic circuits; and a high voltage power supply in communicationwith a coil and matching network, wherein the high voltage supplyincludes a bridgeless gallium nitride transistor, programmable, totempole boost converter configured to convert received radio frequencyvoltage to stable, higher voltage direct current.
 8. The inflatablemedical implant inflator system of claim 7, further comprising animplant microcontroller in communication with the low voltage powersupply, wherein the implant microcontroller comprises at least onecomputer, at least one nonvolatile memory, at least one pulse widthmodulation unit and at least one analog-to-digital converter.
 9. Theinflatable medical implant inflator system of claim 7, furthercomprising a power inverter in electrical communication with the lowvoltage power supply, the high voltage power supply, and the pulse widthmodulation unit, wherein the power inverter comprises a gallium nitrideor metal-on-semiconductor field effect transistor 3-phase halfcontrolled bridge circuit to invert high voltage direct current into3-phase pulse width modulation alternating current voltage to drive a3-phase induction motor.
 10. The inflatable medical implant inflatorsystem of claim 7, further comprising a power inverter in electricalcommunications with the low voltage power supply and the pulse widthmodulation unit, configured to directly regulate and invert varying highvoltage direct current into stable 3-phase pulse width modulationalternating current voltage to drive a 3-phase induction motor.
 11. Theinflatable medical implant inflator system of claim 5, wherein the atleast one circuit board comprises certifiable MR-Conditional electroniccircuit boards having electronic components mounted thereon, coated formoisture proofing and stability.
 12. The inflatable medical implantinflator system of claim 5, wherein the at least one circuit boardcomprises least one circular circuit board the same diameter as the atleast one motor, the at least one circular circuit board having a holein its center.
 13. The inflatable medical implant inflator system ofclaim 5, further comprising a voltage sensor in electrical communicationwith a microcontroller, wherein the microcontroller is configured to:use the data from the pressure, voltage, and temperatures sensors forfeedback control of the 3-phase pulse width modulation signals tooptimize motor operation during a pumping cycle; and use the data fromthe pressure, voltage, and temperatures sensors for detection of implantfailures including motor under and over speed, under and over electricalcurrent and voltage, fluid leakage, short circuits, over pressure, andover temperature.
 14. The inflatable medical implant inflator system ofclaim 5, further comprising a pressure relief tube in fluidcommunication with the at least one inflatable medical implant.
 15. Theinflatable medical implant inflator system of claim 5, furthercomprising a patient external controller comprising: an energy source tooperate the patient external controller and the pump in reservoirimplant; patient controls; a display; a microcontroller in electricalcommunication with the patient controls and display; an encrypted,nondestructive computer memory in electrical communication with themicrocontroller, the encrypted, nondestructive computer memory storingcomputer instructions, pump in reservoir inflation parameters, andsafety data for transmission to the pump in reservoir implant, andoperating parameters received from the pump in reservoir implant tocreate an operational history; a resonant alternating current powertransmitter in electrical communication with the microcontroller and inwireless communication with the pump in reservoir implant; abidirectional radio frequency link in in electrical communication withthe microcontroller and in wireless communications with the pump inreservoir implant, configured to transfer computer instructions, controlsignals and data to and from the pump in reservoir implant; and acommunications interface in communication a medical provider softwareapplication, configured to transfer computer instructions and controldata from the medical provider software application and to transfer pumpin reservoir operational history data back the medical provider softwareapplication.
 16. The inflatable medical implant inflator system of claim15, wherein the communication interface receives instructions from themedical provider software application to operate at the least oneinflatable medical implant.
 17. The inflatable medical implant inflatorsystem of claim 16, further comprising: a data feedback loop from thepatient external controller to the medical provider software applicationwhich receives patient and inflatable medical implant data includingfluid pressure, time between operations and pump operating time; and ananalytics module, wherein the medical provider can analyze receivedpatient data to determine inflatable medical implant performance trendsacross patient and across devices and determine that a particular deviceis about to fail.
 18. The inflatable medical implant inflator system ofclaim 15, further comprising a radio frequency power transmission safetysystem in which no high voltage is transmitted by the patient externalcontroller until a handshake with the pump in reservoir implant iscompleted, there are no faults detected in the pump in reservoirimplant, and a foreign object detection process is successfullycompleted.
 19. The inflatable medical implant inflator system of claim15, further comprising a resonator pad including a coil in electricalcommunication with a radio frequency matching network and powertransmitter and in wireless communication with the pump in reservoirimplant.
 20. The inflatable medical implant inflator system of claim 5,wherein the at least one inflatable medical implant includes an analcuff and a urethra cuff, and wherein a microcontroller is configured tolower pressure during low patient activity times.
 21. The inflatablemedical implant inflator system of claim 5, wherein the at least oneinflatable medical implant is an inflatable penile implant, and furthercomprising a pressure transducer and audio power amplifier in fluidcommunications with the inflatable penile implant.
 22. A method for apatient to wirelessly operate an inflatable medical implant system,comprising: transmitting power and control signals from a patientexternal controller, wherein the patient external controller includes apower source, wireless power and control transmission circuitry andpatient controls; receiving the control signals and power at a pump inreservoir implant in wireless communication with the patient externalcontroller, wherein the pump package includes a fluid reservoir, circuitboards, at least one motor, at least one pump, at last one valve andpressure and rpm sensors, and wherein the circuit boards, at least onemotor, at least one pump and at least one valve are submerged within thefluid reservoir; and activating at the least one motor, the at least onepump and the at least one valve in response to receiving power andcontrol signals to inflate at least one inflatable medical implant,connected to the pump in reservoir implant through flexible tubing.